Saturday, May 16, 2020






Facemasks and Social Distancing
Zach Zachariah, Ph. D., M.B.A., Associate Professor Emeritus, Ohio University
May 15, 2020

On Monday April 27th, when Ohio Governor Mike DeWine rolled out Phase 1 of his plan to reopen businesses, he said, “no mask, no work, no service, no exception.”  The next day, DeWine who required facemasks for everyone, reversed his decision by making it mandatory for employees only and not for customers. He said, "We heard from a lot of different people who felt that 'I may wear a mask, but the government should not be telling me what to do.'”  I wish he had not reversed his decision.

Surgical masks and other face coverings do not offer full protection against a heavy load of Coronavirus.  However, they will prevent aerosol droplets released when a person sneezes, coughs or even talks loud from spreading to the surroundings.  Coronaviruses are denser than other pathogens and they drop to the ground within six feet, a distance considered safe to be away from the next person. Assuming that most store-goers do not sneeze or cough, there is only a slight chance that a person who does not cover the face may breathe viruses from the air, if a safe distance is maintained. Coronaviruses stay on hard surfaces for several hours. That is the reason why stores are thoroughly cleaned and carts, checkout counters and conveyer belts are frequently wiped down. It is still possible that one will touch surfaces that may have virus droplets.  When we touch our nose and face with our hands, the virus can enter the body. The advantage of having a facemask is mainly to protect you from the virus rather than protect fellow customers from you.

During the time the stay-at-home order was in place, I noticed about 90% of the shoppers covered their face.  Two days ago, I went to Walmart at a less busy time and counted eight people in the 20-50 age group without any face covering.  This is about 30-35% of the shoppers I encountered.  It is quite possible that some of them have touched their face or nose with their hands.  What if one or two of them touched a surface that harbored Coronavirus from an asymptomatic person. These people would be going home to an elderly relative or someone with an underlying condition. Such a behavior is enough for the disease to spread in the community.

Later that day I watched on YouTube, a clip of the PBS program, Amanpour & Co in which  Hari Sreenivasan interviews Dr.  F. Perry Wilson, a researcher from the Yale University School of Medicine. The video can be viewed by clicking here[1]. 
Dr. Wilson Interview on PBS

Even if you are unable to watch the whole video, watch at least the last two minutes beginning at about 15:30 minutes.  This is a synopsis of the doctor’s message:
  • Americans cherish individual liberty and do not like to be told what to do.
  • They have embraced shared sacrifice during times of war.
  • Wearing a mask and keeping a safe distance in public are behavioral changes that everyone should be able to make.
  • Leaders must lead by example. Challenge the people to be patriotic and tell them that ‘we need to work together to save this country from this pandemic.’  President Trump has declared that he will not wear a facemask.  Many state governors and mayors have been seen wearing masks.  If these leaders will demonstrate by example and talk about shared sacrifices, then people will come together.
The doctor also explained how misinformation related to medical research is carried on air and on social media.  In the four months since the pandemic, so much data has been collected.  Pre-prints of several studies have been published without adequate peer review.  Data can be interpreted in multiple ways.  What media initially reports is usually one interpretation of the data by a set of researchers. When other experts look at the published data, they may come up with an alternate interpretation.  Further research may even disprove the findings. These new results may not even be publicized.

In another segment, Dr. Wilson talks about the rate of false positive results from the antibody tests on a limited number of persons, which when adjusted for the population may be as high as one third. Since it is not feasible to administer the PCR test for the entire population, the most viable option, in the absence of treatment and vaccination, is for the CDC and other public health agencies to test a representative sample of the population using “Seroprevalence Surveys.”[2]

A Raleigh, North Carolina native hired an airplane to display this message over the city, which I thought was poignant:
“Fewer graves if we reopen in waves.”


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[1] Dr. Wilson Interview on PBS, https://www.youtube.com/watch?v=m8EBHXrum-M
[2] Seroprevalance Surveys, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1580051/
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Saturday, May 9, 2020

The Kerala Model – Testing, Isolation and Contact Tracing
How the model compares to Vietnam and California

 Zach Zachariah, Ph.D., M.B.A., Associate Professor Emeritus, Ohio University
May 9, 2020
Kerala, the state where I was born lies on the Southwest coast of India on the Arabian Sea near the equator. It is the twenty-first of the twenty-eight Indian states in land area and has one of the highest population densities.

 Two other areas of the world chosen to compare Kerala’s success in mitigating the Covid-19 pandemic are Vietnam and California. Vietnam that borders China, where the novel-Coronavirus originated, was able to contain the spread of he virus and not a single person has died from the disease. California is ten times larger than Kerala in land area; but has only six million more people living there. Both Kerala and California encountered the first novel coronavirus case by the end of January 2018. While Kerala has only 504 reported cases and just 4 deaths so far, California has reported 63,700 cases and over 2600 deaths.
Experience: The deadly Nipah virus infection was first detected in the Kozhikode district of Kerala in May 2018. The state government responded quickly, within days traced, and isolated everybody who had contact with the infected. The outbreak was contained in just two districts. It claimed seventeen lives and by the end of June 2018, Kerala was declared Nipah-free.[1] Virus is a Malayalam movie set against the backdrop of the 2018 Nipah virus outbreak in Kerala and is available on Amazon Prime.
Preparedness: Based on the lessons learned during the Nipah outbreak, Kerala government has strengthened the disease response infrastructure by putting in place a 24-member task force coordinating with police and public officials around the state. Operating procedures and protocols were set in place in anticipation for the next epidemic. When the state became aware of the new Coronavirus disease spreading in China, the health minister, K.K. Shailaja, a former science teacher set in motion the government machinery as the first person, a student from Wuhan, China arrived. She was immediately isolated and when tested was found to be Covid-19 positive becoming India’s first Coronavirus case (K. K. Shailaja interview on NDTV)[2]. On February 2, 2020, the government of India issued a travel advisory asking people not to travel to China and said that anyone with travel history in China could be quarantined.
Investment: Kerala has been ruled by left and center-left parties. The left-leaning governments maintained its focus on social welfare. RT America TV interviewed the historian and author, Vijay Prasad about Kerala’s response to Covid-19 and the video on YouTube[3] can be viewed from this link. The state has also invested heavily in education and public health initiatives. It has a 94% literacy rate, the highest in India. Its government run health-care system consisting of primary health centers in rural parts of the state, specialty district hospitals and a number of medical colleges and teaching hospitals is ranked the best in India. Kerala has a vibrant local media that disseminated Covid-19 information without regard to political affiliation. Most people in the state realized the seriousness of the situation, followed government guidelines on social distancing, personal sanitization and sheltered in place during the lockdown.
Response to Covid-19: A family of three, who arrived from Italy on February 29, skipped the voluntary screening for Covid-19 at the airport and traveled to their hometown. They developed the disease and infected two elderly grandparents.The District Collector, a career public servant who belongs to the prestigious Indian Administrative Service (IAS), resorted to the WHO recommended plan of contact tracing, isolation, and surveillance. He mobilized a team of law enforcement and public health officials, paramedics, and volunteers to retrace the family’s movements through cellphone data and interviews, tracked down the contacts, and isolated them. He also set up a call center in his office, bringing in more than 60 medical students and staff from the district’s health department, whose job was to call everyone isolating, every day[4]. All the five persons survived including the two
elderly relatives. One child and three adults died in Kerala of the disease; two of the adults were in their sixties and one was 71. More than 50% of the deaths in the United States and Western Europe occurred in the nursing or eldercare homes. A recent headline in the Washington Post says, “America doesn’t care about old people.”[5] Unlike the more developed countries, Kerala cared about the old.

When an outbreak of new cases occurs, thousands of state-employed health workers and volunteers equipped with maps and flowcharts conducted aggressive contact tracing and brought the situation under control. As the number of Covid-19 cases grew to 15, the state chief minister, Pinarayi Vijayan, ordered a lockdown, sealed state borders, restricted public and private transportation, closed schools, and banned gatherings larger than ten including religious services. The government also quarantined hundreds of thousands of migrant workers in camps and provided them with free food.

 Kerala promulgated an Epidemic Disease Ordinance on March 29, 2020, days before the central government instituted a harsh lockdown. It included an economic package worth $2.6 million (₹20,000 crores) to fight the pandemic. The government entrusted the task of implementing the economic package to the nationally acclaimed poverty eradication and women empowerment program known as Kudumbashree[6]. This organization that is spread throughout the state has over 5 million members in 430,000 ward level units. They organized community kitchens to cook and deliver food to the needy, especially to the families of schoolchildren. Kudumbashree volunteers also assemble grocery kits and deliver them to 8.7 million families. It formed 200,000 WhatsApp groups to provide Government instructions regarding Covid-19 to dispel fake news. Mental health helplines were also established across the state[7]. The state liaised with service providers to increase network capacity for Internet and promised two months of advance pension.

 In an interview  with TimesNow[8], the chief minister of Kerala detailed how the government harnessed the resources of the state’s Innovators and entrepreneurs to design and manufacture PPFs, respirators and ventilators. According to him, hotel rooms, hostels, and additional buildings were being identified to accommodate a surge if that happens. As the Indian government is easing travel restrictions, Kerala expects tens of thousands of Keralites to return from overseas. While still keeping the social distancing guidelines in place, the state is preparing to quarantine returnees for seven days after which they will be tested for the disease and only those found negative will be released for an additional week of quarantine at home.

Update (May 11, 2020): 
On May 10, 2020, the government of Kerala has issued new guidelines on quarantining the returnees[1].  Every returnee will be screened on arrival for Covid-19, asymptomatic persons will be required to adhere to strict home quarantine rules for 14 days and those who show symptoms will be admitted to specially designated Covid hospitals. Those under home quarantine show symptoms, they will be tested and if found to be positive to the virus, will be transferred to a hospital for treatment.



 
[1] Lessons from Kerala’s bold fight with Nipah https://www.orfonline.org/expert-speak/42270-lessons-from-keralas-bold-fight-with-nipah/
[2] Health Minister K. K. Shailaja Interview on NDTV, https://youtu.be/q9xQljHg21c
[3] RT America, the Model State, https://youtu.be/7AGI6qVVmpo
[5] Washington Post, America doesn’t care about old people, https://tinyurl.com/y9jzk6l3
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Tuesday, April 28, 2020

New Covid-19 Cases in Several Countries

Zach Zachariah Ph.D., M.B.A., Associate Professor Emeritus, Ohio University
April 28, 2020

Around 2:00 PM (ET) today, the number of confirmed Covid-19 cases in the United States surpassed the 1,000,000 mark. U.S. now has one-third of the total reported cases in the world.The death toll as of today is 57,000.[1]  The five-day average (April 24 thru April 28, 2020) of the number of new cases reported in the U.S. is a staggering 30,221. The rate of new cases has plateaued so also the number of deaths reported. Even though the number of new cases reported is not increasing exponentially, it has not yet shown a downward trend. 

 The Financial Times [2] tracks the spread of the new Coronavirus pandemic worldwide and produces charts comparing a seven-day average of data for daily death toll, new deaths, and new cases. This International daily newspaper headquartered in London has made available for free their Coronavirus coverage.  Here is the latest chart on new cases reported from several countries of the world.  

Source of Chart:  Financial Times
An Explanation About the Chart from Financial Times
Linear Scale vs. Log Scale (Click to Play)
  • The charts that most of us are familiar with are linear. The values between two points do not change. The y-axis of this chart from the Financial Times uses the logarithmic scale, which is based on exponents.
  • The video from Vox [3] explains the difference between a linear scare and a log scale. It is based on the number of reported Covid-19 cases, not just new cases.

Some of the highlights:
  • The number of new cases is on the decline for most countries of the world including Italy.
  • Only three countries with the highest total of new cases, the United States, U. K., and Spain, have not shown a decline in the number of new cases.
  • However, the new Covid-19 cases have plateaued in the three countries indicating that the measures taken by the authorities to shut down or mandate a shelter-at-home and asking everyone to cover faces and maintain physical-distancing when outside, have flattened the curve.

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An Updated Chart Comparing Responses to Covid-19 by U.S., India and States Within

The chart has been updated with data available as of April 25, 2020.  While there is a plateauing of the number of cases in the places shown, the number of new cases and the deaths are still not declining.
   
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Thursday, April 9, 2020

Ohio and Cuyahoga County Stats on Reported Number of Cases - Covid-19


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Tuesday, April 7, 2020

Covid-19 Cases and Forecast - Cuyahoga County and Ohio

Zach Zachariah Ph.D., M.B.A., Associate Professor Emeritus, Ohio University
April 7, 2020

 Reported Coronavirus Cases for Ohio and Cuyahoga County


Comments:
  1. These are actual data from the Ohio Department of Health [1] website and Cleveland.com [2]
  2. The number of cases for Cuyahoga County for April 3 (780) and April 4 (781), and the numbers for Ohio for the same two dates, 3312 and 3379 did not follow the general pattern.
  3. Since then, the daily number of confirmed cases has been increasing exponentially although at a slower rate, indicating a possible flattening..

Forecasts for Cuyahoga County and Ohio


Comments:  
  1. I am not a statistician; but I do understand the math (differential equations) behind mathematical modeling.
  2. These forecast charts were created with the tools available on Excel Spreadsheet.  They appear to match some of the mathematical models seen elsewhere.
  3. The CEO of Cleveland Clinic Dr.Tomislav Mihaljevic was on MSNBC's Morning Joe on April 3, 2020.  Watch the video [3]
  4. The Clinic has been making preparations since early January.  According to Dr. Mihaljevic if we practice Social Distancing, the curve would be flattened with the peak occurring between mid May and mid June for Ohio.
  5. The Director of Ohio Department of Public Health, Dr. Amy Acton has said that she expects Ohio's Coronavirus cases will reach a plateau by the end of May.
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[3].  Cleveland Clinic CEO Interview, https://www.youtube.com/watch?v=ocj9EjI9kgo
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Thursday, April 2, 2020

COVID-19 – Rumors, Conspiracy Theories & Fake News
Zach Zachariah, Ph. D., MBA.
Associate Professor Emeritus, Ohio University
April 2, 2020

These or some of the rumors and fake news regarding the origin of the Coronavirus that is being circulated on social media:
1.       The virus has been created by inserting herpes bits into corona RNA.
2.       The Chinese created the virus and spread it to the world to create chaos.
3.       China spreads the news that the US Army started the Coronavirus
4.       They quickly controlled the epidemic in your country. After all, they already had the antidote.
5.       The coronavirus travelled entire world from Wuhan but it did not reached Beijing and Shanghai.
Here are the facts:
The first report of the outbreak of the current pandemic was confirmed on December 31, 2019 in Wuhan, in the Hubei Province of China and the first death was reported on January 11, 2020.  Bats are the natural reservoir of coronaviruses.  These viruses cannot directly get into humans; there must be an intermediate host (animal or bird). A study by Yang Zhang and colleagues of the University of Michigan, U. S. A. published in the ACS’ Journal of Proteome Research[1], which is quoted in the publication, Science Daily (March 26, 2020) suggested that the host animal is pangolin, which the Chinese eat.  The researchers identified protein sequences in the sick animals' lungs that were 91% identical to the human virus' proteins. Moreover, the receptor-binding domain of the spike protein from the pangolin coronavirus had only five amino acid differences from SARS-CoV-2, compared with 19 differences between the human and bat viral proteins. This evidence points to the pangolin as the most likely intermediate host for the new Coronavirus[2].  Other research laboratories are conducting further studies to understand more about the DNA and protein sequences of the novel-Coronavirus that the W.H.O. has named SARS-CoV-2[3].  We have to remember the fact that it was only in January that the sequence was first identified.
The virus’s genetic makeup reveals that the virus is not a mishmash of known viruses. Anyone hoping to create a virus would need to work with already known viruses and engineer them to have desired properties. SARS-CoV-2 virus has components that differ from those of previously known viruses, so they had to come from an unknown virus or viruses in nature. “Genetic data irrefutably show that SARS-CoV-2 is not derived from any previously used virus backbone,” says Kristian Anderson of the Scripps Research Institute, La Jolla, CA, USA in a study published in Nature[4]. Other independent researchers have confirmed this finding.  These research findings point to the fact that the new Coronavirus was not created by inserting herpes or HIV bits to Corona RNA. There is no evidence that US Army started the Coronavirus either.
So far, in China, the number of people reported to have been infected is 82,691 and 3,321 persons have died.  Of that total, in Hubei Province of which Wuhan is a part, 67,802 people have been infected and 3193 persons have died.  Chinese government might have underreported the numbers.  The government enforced a complete lockdown of the province for over eight weeks, which spared the other major cities from the devastating epidemic.  Even then, 580 persons were infected in Beijing and 516 were infected in Shanghai.  It is preposterous to say that China made the virus to create chaos in the rest of the world allowing the virus to affect so many of its citizens. The Chinese scientists were the first to identify the RNA sequence and then shared it with W.H.O., which made it possible for W.H.O., C.D.C. and other public health agencies to develop the tests to identify the disease and for researchers to work on developing the vaccine. Following the Chinese example, the Indian government has clamped a lock down of the country to contain the pandemic.  The White House Task Force on Tuesday, March 31, 2020 projects that the pandemic will eventually kill 100,000 to 240,000 people in the U.S. alone[5]. Yet, there is no countrywide stay-at-home order and many states have not implemented the social distancing guidelines recommended by the White House. 
Conspiracy theory mongers are always going to come up with wild and exotic theories.  They will continue to post to Facebook, WhatsApp, Twitter and other social media outlets.  Someone from among us will pick it up and post it to a group forum; others will forward it or retweet it, and it will spread just like the Coronavirus.  Take a moment before you forward or retweet and ask a few simple question:  Does it make common sense?  Does it have any factual basis? Am I spreading a fake news?  If the answer is no, please take the mouse or your finger off that post or tweet.
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[1]Protein Structure and Sequence Reanalysis. https://pubs.acs.org/doi/10.1021/acs.jproteome.0c00129#
[2] Missing Link,  in Coronavirus- Science News, https://www.sciencedaily.com/releases/2020/03/200326144342.htm
 [3] Features, Evaluation and Treatment COVID-19, https://www.ncbi.nlm.nih.gov/books/NBK554776/
[4] The proximal origin of SARS-CoV-2, https://www.nature.com/articles/s41591-020-0820-9
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Monday, March 30, 2020



COVID-19 – Is New York a Prelude to Florida and Beyond?

Zach Zachariah, Ph. D., M.B. A.
Associate Professor Emeritus, Ohio University
March 30, 2020
Number of Covid-19 cases in the U. S.:  The United States has now surpassed all other countries in the world including Italy, Spain and China as the number one country with the total number of confirmed Covid-19 cases at 144,410.  That is close to 20% of the total reported cases in the World.  Approximately 1.8% of those infected (2,600) have died.  In the U.S., New York State leads with 60,679 cases, which accounts for 42% of the total number[1]. More than half of the cases (33,500) are in New York City.  Close to a thousand persons have died of Covid-19 in the city alone including a renowned surgeon, a nurse and a police detective. 
The White House coronavirus coordinator estimates that this pandemic could kill 100 to 200,000 Americans[2].  Over 10 million people have to be infected for that many people to die. Initially, the vast majority of cases were in coastal states like Washington, California, New York and New Jersey. More cases are being reported from Michigan, Florida, Illinois, Louisiana and Georgia.  Cook County, of which Chicago is a part, reported 3,445 cases. Detroit (1,542), New Orleans (2,100), and Miami-Dade County (1472) - the number of cases are in parenthesis - have been identified as hotspots where there is a surge in hospitalization resulting in shortages of supplies, staff, personal protective equipment (PPE), ventilators and ICU beds. Houston and Dallas are not far behind. This graphics (Click on graphics to watch the YouTube video) from yesterday’s CNN program[3], is a good illustration of how the number of confirmed Covid-19 cases surged in the different regions of the country. 
https://www.youtube.com/watch?v=EKQ0AasW8yI&t=3s


New York State and New York City Stats: The first reported case of Covid-19 in New York was on March 1, 2020.  On March 6, the number of cases doubled to 44 from the previous day.   
The next day, the number was 89 and Gov. Andrew Cuomo declared a state of emergency. On March 14, the first death was reported and the number of cases reached 524.  On that day, the number of cases in New York City was a mere 464. In another week, the number of cases in New would reach 15,000 and the city would report 8,115.  By March 29, the number of cases for New York State would be 59,648 (a 300% increase) and New York City would report 32,300 cases (242% increase) and 1,543 deaths.  It took 12 days for the number to reach 100 and in the next 10 days, that number reached 10,000.  The growth pattern is still exponential.  (See graph on the right). Although the City is under strict-stay-at-home orders, the peak will not be reached for at least three weeks.  Mayor de Blasio made a grim prediction that half of New York City population (4.2 million) would be infected. New York City is now the epicenter of the Coronavirus crisis, partly because of its population density.  Millions of travelers from all over the world came into the three International airports in the area without being tested or monitored. Many of them would have been asymptomatic carriers of the virus. 

How to flatten the curve?  Without any intervention, the trajectory of the epidemic curve will be exponential with the apex or the big peak happening at some point in time before coming down.  At his point, the hospitals will become overwhelmed and will be unable to provide care to the critically ill patients. 
China, by quarantining the inhabitants of a whole province was able to flatten the curve and shift the peak to a later date, which reduced the burden on the hospitals and the healthcare workers.  The total number of infected cases under each peak is the same except that the protective measure taken would flatten the curve to meet the health care system capacity.  Such a drastic step was not adopted in many other countries.  Instead, countries such South Korea, Singapore, Taiwan, Hong Kong and Iceland ramped up testing of as many people as possible to identify those infected and isolated them for 15-21 days.  Another strategy being implemented by countries like USA and UK is to impose travel restrictions combined with public health interventions (banning sports events and other mass gatherings, asking people to stay and work at home) and individual behavioral changes (keeping safe distance, handwashing) has been found to be effective[4].   We still need data on the number of cases, which in turn requires widespread testing of the population.  The numbers reported in the United States do not show the full picture in many parts of the country, mainly because of the inadequacy of testing.  Watch the video[5] to understand what it means by “flattening the curve” and the importance of social distancing.

Have we flattened the curve?  In almost all the states in the United States, the trajectory of the epidemic curve is exponential. USA Today has an excellent set of charts that compares the number of Covid-19 cases in each state to New York[6]. One notable exception is the state of Washington that reported the first Covid-19 case. The state governor had implemented strict social gathering rules by closing down restaurants and bars, restricting large gatherings and issuing stay-at-home orders. Until March 24, the state had the third-highest levels of Covid-19 cases behind New York and New Jersey.  Today it is number seven in the list of states.  In New York, the number of new cases reported increases only at a slower rate in the last few days.  This trend, if continued in the coming weeks, will indicate that strict measures taken do help flatten the curve. Yesterday, the President extended the federal guidelines on social distancing by a month after suggesting that he will open up the country for business on Easter Sunday.

What about the parts of the country that have not implemented the strict guidelines:  There is still no countrywide order to stay-at-home.  As of today, citizens of 30 states, 82 counties, 18 cities, the District of Columbia and Puerto Rico are being urged to stay home, which leaves out at least 80 million people that are not mandated to observe social distancing[7].   Florida is a case in point.  Today, Gov. Ron DeSantis announced a "Safer At Home" executive order until the middle of April, which encourages people to stay inside and practice social distancing to combat the coronavirus pandemic.  However, this order applies only to the four Counties:  Miami-Dade, Broward, Palm Beach and Monroe.  While Monroe County only has 24 reported cases, Tampa area itself has 116 cases and the governor’s order does not apply there although Hillsborough County has issued a similar order.  Unless the other states, many of them in the South do not institute strict social distancing guidelines, the chances are that they will begin to see spikes in the number of persons infected.

How all these matter to us?   I picked several of the places mentioned because majority of Malayalees, many of them Knananites live and work in these places.  Even in places like Ohio, we have a good number of our own healthcare professionals in he forefront of this epidemic trying to save the affected persons. Vast majority of them are nurses, respiratory therapists, nurse practitioners, pharmacists and doctors. Let us take a moment to thank them. We will soon start hearing reports of our own family and friends being infected and die. I am editing this blog on Sunday, April 5, and yesterday, heard the report of the first death due to Covid-19 of a Knananite in New York City .  For social distancing to work to flatten the curve, each individual should do his/her part to follow the guidelines.  We can help to minimize the spread of Covid-19 by staying at home and maintaining safe distance when going to a store.  Let us pray that all of our near and dear healthcare professionals stay safe and healthy.      

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Sunday, March 29, 2020



COVID-19 – Origin and Spread

Zach Zachariah, Ph. D.
March 29, 2020
What is Covid-19 and its symptoms?  The most recently discovered coronavirus that originated in China causes coronavirus disease COVID-19.[1]  Common cold, influenza, and the new Coronavirus share similar symptoms with some significant differences.   
How did humans contract the virus?  The first report of the outbreak of this pandemic was confirmed on December 31, 2019 in Wuhan, in the Hubei Province of China and one person was confirmed dead on January 11, 2020.  Bats are the natural reservoir of coronaviruses.  These viruses cannot directly get into humans; there must be an intermediate host (animal or bird). The suspected animal is pangolin, which the Chinese eat.[2]  There have been rumors that it was a virus the Chinese or the Americans created in the labs and used as a biological weapon to infect people.  According to the new findings, the virus’s genetic makeup reveals that it is not a mishmash of known viruses[3], which disproves the rumors and certain politically motivated propaganda[4].
Spread of the Virus:  The first confirmed case in the US was in Washington State on January 20, 2020.  The patient was a 35-year old man who returned from Wuhan, China. In a little over two months, there are now 125,000 confirmed cases in the US and 2250 persons have died.  Almost half of the cases are in the New York State. As of yesterday, there are 1,406 confirmed cases in Ohio. Of the total, 370 (approximately 82% are above the age of 50) are in the Cuyahoga County of which Cleveland is the County seat[5].  The Chinese government completely shut down the whole Hubei province, which helped to contain the spread of the disease, yet killing 3,300 persons out of the 81,439 infected.  It prevented to some extent the disease from spreading to other parts of China. It is impossible to shut down the whole New York City or the state and quarantine all inhabitants.  Several states and a number of major cities have ordered people to stay-at-home, and non-essential businesses to close. We can only help to minimize the spread of Covid-19 by staying at home and maintaining a safe distance.  Let us all pray that the healthcare professionals stay safe and healthy. 

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